Rebuilding Ryan

A year after the Red Sox top prospect found himself suddenly unable to see and confined to a wheelchair, he has survived dangerous brain surgery, undergone extensive rehabilitation, and returned to the minor leagues to try to relearn everything.

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The afternoon is fading, and he is standing in the lobby of a salesman’s hotel in Cleveland Circle in Brookline. He looks like any other kid in a gray sweat suit, but you notice upon meeting him that the left side of his face has kind of a slide to it and that his speech is just a bit waterlogged. Ryan Westmoreland has come up to Boston to have those particular problems looked over at Massachusetts General Hospital. He left only this morning from the Red Sox spring training facility in Fort Myers, Florida. He did his workout, and his stretching, and his hitting, and his weight lifting, and all the other things that baseball players do every day to get ready for the season. Then he went in and did all the things he does that most baseball players don’t have to do, because these things are part of his life now.

A year ago, when he got to Fort Myers, Ryan Westmoreland was known to most people as the most promising young baseball player in the Red Sox farm system. Two years removed from Portsmouth High School in Rhode Island, where he had been a pitcher, outfielder, and infielder, Ryan was judged by Baseball America, the acknowledged bible of such things, as “a potential 30-30 player” (they mean home runs and stolen bases) who might one day bat third in the Boston lineup. He was an enormously gifted baseball talent. To thousands of people, he was a line of pretty statistics and an amorphous figure of rosy promise. It was entirely possible that he could have spent his entire life as that, living comfortably with the “Ryan Westmoreland” that his growing fame and burgeoning talent were building for him.

Within a month, he couldn’t see.

Within a month, he couldn’t hear.

Within a month, he couldn’t feel his lower extremities on his right side, those fingertips numb. He couldn’t tie his shoes. It is said of all great people that, like the rest of us, they put their pants on one leg at a time. Ryan Westmoreland couldn’t put on his pants at all.

The individual people who live their lives as athletes live them out side by side with constructed identities, public doppelgangers created by their talents and fashioned in every aspect by the worth that society places on those talents. There are athletes whose basic humanity becomes utterly subsumed by the identities that are built for them, a process in which they usually are more or less complicit. And the great majority of them don’t know that this has happened at all until something – simple aging, a catastrophic injury, legal problems – explodes the constructed identity and leaves them with nothing but their essential human identity, which they may not even recognize anymore. Those who have managed to hang onto their basic humanity, their fundamental sense of their actual identities, are the ones who survive. The others are lost, and often to themselves, most tragically of all.

Contrary to the old sportswriting maxim, they are not always merely what they do. Over the past year, Ryan Westmoreland had to teach himself how to relearn all the most basic things that made him the person he was before he ever picked up a bat. He had to learn how to remember how to do things he had learned to do before. He had to visualize how he used to look when he ran, because that would help him remember how to run again. He was 19, and he had to wrestle with the most basic question of all. He had to learn how to remember who he really was.

“In the past, I was known as the 19-year-old who was the top prospect with the baseball thing,” he says. “Now it’s the 19-year-old who used to be the top prospect and current brain-surgery rehab guy. I’m just looking to be one of the guys again.

“This was my third surgery. I mean, I’m only 20, right?”

***

One day, in the summer of 2009, Ryan was playing for the Lowell Spinners. He was right where he had wanted to be the previous year, when he was graduating from high school and trying to decide whether he would sign a professional contract or go off to Vanderbilt University, which had offered him a baseball scholarship. He had been on the radar of Major League scouts ever since the summer between his junior and senior years. “The first few practices of his senior season,” recalls Dave Ulmschneider, his high school coach, “the Indians scout was there. The Angels scout was there. Ray Fagneant from the Red Sox was there. The Yankees were there, and so were the Mets.”

Ryan grew up as the kid in the neighborhood who could play any game immediately after you handed him the ball, but it was baseball that lighted him up. His father, Ron, had played and coached at Eckerd College in Florida, and he had two uncles involved in pro ball. “I really looked up to my Dad and my uncles,” he explains. “They always played and talked about it, so that was really motivational for me.” As his reputation grew, so did the crowds around the batting cage when Portsmouth came to town. In fact, Ulmschneider was often importuned by scouts to have Ryan come out after the game and take batting practice again, this time with a wooden bat. (Once, Ryan was called out of his last-period English class to take some swings for the Yankees.) At one point, it became almost comical; the Yankee scout would hide behind a shed and wait until the Red Sox scouts left, and then come out and watch for himself. Eventually, the Red Sox got Ryan in the fifth round of the 2008 draft and met his call for a $2 million signing bonus. Not long after that, and right at the signing deadline, Ryan texted his father. He really wanted to go to Vanderbilt.

“My jaw hit the ground, because the Red Sox came up with the number we’d asked for,” Ron Westmoreland remembers. “I had to go to a quiet part of the house to talk it through with him.” Ryan and his father then had what they both refer to as the “Hour and Ten Minute Conversation.”

“I said, ‘Ryan, it’s your decision and I’ll support it, and your mom will support it.’ We talked about everything – the possibility of injuries and of not getting a shot at professional baseball, about financial security based on the signing bonus. He has a chance for a college education, any time he wants it, as part of his signing.” Ryan decided to go with the Red Sox. Ron thought it was the toughest decision his son would ever have to make.

Ryan moved along through the Red Sox system, coming back from surgery for a torn labrum in his throwing shoulder and ending up with the Spinners – at first as a designated hitter because of the surgery and later as an outfielder – on that summer day in 2009. Up in the stands, Charlene Colameta, a student at University of Massachusetts Lowell, had come to the game with friends. She was from Ashby, in north-central Massachusetts, and she was going to school and working part time in the dean’s office. Charlene’s mother had been partially disabled by a stroke when she was 29. Charlene told the usher that she had come to a Spinners game 10 years before, when she was 13, and that she had done the Chicken Dance on top of the dugout. She asked the usher whether she could do the Chicken Dance on the field with the younger kids. When she was finished, she rejoined her friends in the stands, and the usher brought her a baseball. On it was written “No. 25” and a phone number.

“It shut me up completely,” she says. “I thought, ‘Who is this arrogant person sending me this ball?’ I threw it back to him, and some kid wound up with it, and he texted Ryan. I got the ball back after chasing the kid. I figured, ‘I got to meet this guy after going through all that.’ ”

They began dating shortly thereafter.

One night, near the end of the 2009 season, the Westmorelands were at a game in Lowell in which Ryan crashed through an outfield wall, making a catch at a crucial time in the game. He did not get up immediately. “I saw his legs moving,” Robin recalls. Ron Westmoreland hurried down to the clubhouse, where Ryan had been taken. Robin followed. Ryan was rushed to the hospital with a broken collarbone that would require surgery. Charlene met them there.

“That was the first of our many dates in the hospital,” she explains. Ron Westmoreland thought it was the scariest thing that had ever happened to his son.

Once again, Ryan worked diligently through his rehabilitation, and went off to spring training in February 2010 feeling as strong as he ever had. Charlene stayed behind to try to finish up her junior year. On March 3, while she was at work in the dean’s office, her cellphone buzzed. It was a picture message from Ryan. Charlene didn’t know what she was looking at. There was an undifferentiated mass with one curious, bright spot in it, about half the size of a golf ball. She called Ryan in Fort Myers.

“That’s in my brain,” he told her.

***

At first, he blamed video games. He had been known to play Call of Duty for hours. “The first thing I noticed was the joystick on the right-hand side. I couldn’t really feel it as much,” Ryan recalls. “I didn’t really know I was playing. I was watching myself playing, but I couldn’t feel it. I thought, maybe it’s something weird in my wrist because I’ve been playing so many video games.” There were other odd things happening, too. He found his right leg weak after only a few minutes playing ping-pong. On the field, the baseball felt as though it were made of iron, and he couldn’t feel the seams under his fingertips. Ryan told the team’s medical staff, and they sent him for an MRI. The other players asked him what was going on, but he didn’t know any more than they did. After the MRI, he went to the doctor’s office, and they showed him the image.

“They said, ‘You see anything different?’ I said, ‘Well, I don’t know too much about what’s supposed to be where, but that bright-looking thing doesn’t look normal.’ ” He took a photo of the MRI scan and sent it Charlene, and he called his father. “My phone rang, and it was Ryan,” Ron Westmoreland says. “He said, ‘I had the MRI and a doctor’s going to call you, and you might want to have a trash can next to you.’ I must have turned white as a ghost.” Ron was on his way to In the Zone, the baseball training facility that he operates in Fall River. When he arrived, he picked up the phone – sobbing at this point – and called Dave Ulmschneider, Ryan’s former coach and Ron’s travel team director, to ask him to handle the club for him. He then drove to Massachusetts General Hospital to join Ryan, who had flown up from Florida and been met by Charlene and a Red Sox representative at Logan. They had a meeting with Dr. Christopher Ogilvy, the director of neurovascular surgery at Mass. General.

They were told that Ryan had what’s called a cavernous malformation of the brain. It is a vascular abnormality, a tumor formed by endothelial cells, which line the blood vessels and form capillaries. They tend to grow, as all tumors do, and can rupture at any time, bleeding either within the cavernous malformation or into the surrounding tissue. The second kind of bleed is more dangerous, and it’s the kind Ryan had. They are benign only in the sense that, unlike cancerous tumors, they do not metastasize. The condition wasn’t even diagnosable until the development of modern imaging techniques like MRI and CAT scans; the symptoms were confused with multiple sclerosis, stroke, and other conditions that cause neurological deficits. The condition can occur throughout the body, but is especially dangerous in the brain and spinal column. Ryan’s was in the worst place; it was on his brainstem, the narrow pathway through which all the nerve impulses pass to the rest of the body.

“The learning process started right there,” says Ron. “I’d never heard of it, and I thought maybe it was some kind of stroke. Nobody

really knew anything about it, but we learned about it pretty quick.”

“I really misunderstood how serious it was, even though I knew it was in my brain,” Ryan says. “When I first found out, I really misunderstood what they were saying.” Ogilvy advised the Westmorelands against surgery because at that point he believed the risks outweighed the benefits. They then went to New York and consulted with Dr. Robert Solomon at Columbia University Medical Center, and he was even more adamant against surgery. He told Ryan that the odds were “80 percent against” his having another bleed. That night, Ryan and Charlene went to see Avatar in 3-D at a theater in Times Square. Ryan developed a headache, which he attributed to the 3-D glasses. “I told him it wasn’t funny and to stop scaring me,” Charlene said. Over the next 24 hours, Ryan fell off a cliff.

He went deaf in one ear. His vision began to blur. They went back to Solomon. “He walked into the doctor’s office,” Charlene recalls, “and he came out in a wheelchair. The rate of progression was unbelievable. You see him sitting there and you know you can’t do anything for him, and then he starts to blink . . . differently.”

The malformation had begun to bleed again. “The second bleed wasn’t supposed to happen,” says Robin Westmoreland. “If there was a third, we didn’t know if he could survive.” They went back to Boston and met with Mass. General’s Ogilvy again and with Jim Rowe, the Red Sox medical operations coordinator. The talk returned to surgery. There were considerable risks, given the location of the malformation. Ryan could have the hiccups the rest of his life. He could be paralyzed or in a coma. He also could die. The Red Sox arranged a conference on Skype with Dr. Robert Spetzler, chairman of neurosurgery at the Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center in Phoenix. Spetzler had chosen this particular adversary as one worthy of fighting for an entire career.

Almost from the start, the Westmorelands were impressed with Spetzler’s confidence in his ability to perform the surgery that the other doctors had said Ryan should try to avoid. (Spetzler has performed more than 300 procedures to fix cavernous malformations. Nobody else in the world has done more than 100.) “I had one guy who was in the middle and one guy who was against it. I never heard anything positive about the surgery,” Ryan says. “Then Dr. Spetzler said right away, ‘I’d do it on my own son right now.’ I wasn’t looking for a cocky guy, but he was so confident about what he was doing that it helped me out a lot. I was in such a state of being unsure.”

Red Sox owner John Henry flew the Westmorelands and Charlene out to Arizona in his plane. Ryan’s parents kept saying how great the plane was, but Ryan couldn’t see anything. Once there, they spent a couple of days getting acclimated; they visited Chase Field, where the Arizona Diamondbacks play. The night before the surgery, they went to an Outback Steakhouse. Ryan was in a wheelchair and having trouble sitting upright. But seeing her distress, Charlene recalls, “he made me laugh” to ease her pain. They woke him up at 4 in the morning to get him ready for surgery. “He went in, and we didn’t want to say goodbye,” recalls Charlene, who’d taken time off to be with Ryan. “That hurt. I was, like, ‘See you in a little bit.’ ” She says Ryan said, “I’m just going to take a nap.” She rejoined the Westmorelands in the waiting room.

By then Spetzler had assembled his eight-man team. He had no illusions about the delicacy of the operation. “The brainstem is like the cable between the computer and the screen,” Spetzler explains. “All the function passes through that, and it’s about as big as your thumb. There are millions of fibers passing through there, and you have this lesion on the brainstem. The secret is to get to the cavernous malformation in a way that doesn’t hurt other functions of the brain.” He had selected the “path” in Ryan’s brain through which he would get at the malformation. He would go through the middle cerebellar peduncle, a fibrous area in the back of the brain that the MRIs indicated would be the safest route.

“Nervous is not something I get,” Spetzler continues. “The thing is that it’s based on so much experience. But you do get tense, yes. It depends on what’s happening, what’s at stake. There literally is no room for error at all.” He cut a little piece of skull away at the back of Ryan’s head and, using a surgical microscope, image-guidance software, and the MRI images as a map, Spetzler followed the narrow path he had chosen to the place on the brainstem where the malformation was. There, he used an OmniLaser, a relatively new microsurgical system, to break up the structure, and an ultrasonic aspirator, which vibrates at such a high speed that it emulsifies the pieces of the malformation so that they can be sucked up and out. The whole procedure took six hours.

Meanwhile, the stir-crazy Charlene left the hospital, walking aimlessly around Phoenix. Ryan’s parents stayed there, jumping a little whenever a doctor walked in the room or the receptionist answered a call. Finally, Spetzler came out and brought them all into a room not far from the waiting area. It was a small, breathless moment. Ron thought they could hear almost anything at this point.

“It couldn’t have gone better,” Spetzler said.

***

Ryan awoke briefly to find himself in a CAT scanner, but he fell back to sleep. He came around in the intensive care unit, and the first thing he noticed was the plastic tube down his throat. It was dreadfully uncomfortable. He tried to tell someone. “I thought I was talking, but I couldn’t hear me, so I started knocking on the sides of the stretcher,” he explains. “I started going a little mental about it, because it was so uncomfortable, so they strapped me down. They said it was only six minutes before they took it out, but it felt like six hours.” Charlene came in to see him for the first time while he was tied to the stretcher. “It was horrifying to see,” she says, and she left to compose herself. When she came back, Ryan gave her a hand-squeeze. “That,” she says now, “meant everything.”

His rehabilitation started almost immediately under the supervision of Dr. Christina Kwasnica, the director of physical medicine and rehabilitation at the Barrow clinic. “I saw him in the ICU the day after the surgery,” she says. “The therapy actually started in the ICU, because our first task was to get him out of bed and to the neuro-rehab part of the hospital.” They helped Ryan relearn how to get himself into a chair and to the bathroom and then how to take a shower and get dressed. Ryan realized that his job was not just to relearn skills he had long taken for granted, but to relearn how to learn. He had to reconceptualize himself in his own mind, as though he were working on rebuilding the person he once was.

“They didn’t take any excuses,” he says. “It was all rehab all the time.”

Kwasnica was impressed by how firmly Ryan took control of his rehabilitation. “Other athletic injuries, you don’t have to rework yourself on how you get dressed,” she says. “Any kid his age, he’s bound to get a little irritated when his parents are all over him, saying, ‘It’ll be OK.’ I was impressed by him, because he was able to say, ‘OK, I can take care of this myself.’ ”

It was established early on that getting Ryan back on a baseball field was a dim and secondary goal to getting him back simply to being who he was. Nevertheless, baseball kept inching into the proceedings in Arizona. Hall of Fame pitcher Randy Johnson spent an afternoon with Ryan, and Justin Upton of the Arizona Diamondbacks came to visit. The Los Angeles Dodgers’ Andre Ethier’s brother worked at the hospital. And one day Charlene smuggled in a Nerf ball and a Wiffle ball bat. An orderly helped Ryan stand up. Charlene threw the ball and hit Ryan right in the head. If I could walk, he told her, I’d charge the mound.

From the start, the Red Sox were intimately involved with Ryan’s care. The team’s medical staff was learning about his condition – and the rehabilitation program it entailed – on the fly, just the way he was. This was particularly the case when Ryan left Arizona for Boston and the Spaulding Rehabilitation Clinic. Again, Henry offered to send his plane to Arizona to pick up Ryan and his family. The problem was that private planes have private staircases. Ryan had to relearn how to learn to climb stairs again. “In the rehab gym, they have practice stairs,” he recalls. “I worked on them for like a week straight. It was tough for me because we went through different varieties of things – one foot on each stair, then two feet, then go back again – to prepare me for any scenario that might entail getting on a private plane.” When they got to Boston, it was pouring rain.

“I thought I was going down,” Ryan says, “but they had, like, three or four paramedics there to hold me up – to make sure I went one step at a time.”

At Spaulding, the work grew more intense – paradoxically, the smaller the task, the harder the work. Ryan’s mother remembers him going off to do cognitive function drills in the first days of his rehabilitation, one of which involved looking at two pictures and pointing out the subtle difference, and coming back sweating as though he’d done a full workout at Fenway. Now speech therapy ran him ragged. He would sweat and strain to pick up pins and to work something called the grooved pegboard test, in which he had to find and turn the right key, or peg. “It was more than physical,” he remembers. “I was just concentrating so hard.” The therapists, and Charlene, stepped in to help him. She was staying on a cot in his room, just as she had at the clinic in Arizona. “She was tough,” says Robin Westmoreland. “He’d whisper to me, ‘Hey, tie my shoes,’ and Charlene would say, ‘You have to do it yourself.’ ”

Ryan was a patient at Spaulding for three weeks, checking out on April 27, 2010, his 20th birthday. He started outpatient therapy almost immediately, continuing to work with the same team of therapists, who were startled by his progress. “Because he is a sportsperson, he has a lot of the will to work,” says Varsha Desai, the occupational therapist who worked with Ryan on his fine-motor deficits. “He will not get frustrated. He will persevere to get the movement he wants.”

He also came back to baseball little by little. He sat with Theo Epstein in Epstein’s box on Opening Day last season, and, later last summer, he suited up with the Spinners for a few games in Lowell, though he didn’t play. “None of my stuff fit, so one of the coaches loaned me his pants,” Ryan says. “I probably needed help, but I wasn’t going to let anyone help me, not to get into my uniform.” In January, not quite a year since he began to feel oddly, Ryan returned to Fort Myers.

“I never stop being amazed by the brain,” Robert Spetzler muses almost a year after he had removed the malformation from Ryan Westmoreland’s brain. “It makes us who we are – not just our ability to function, but it gives us that extra ability to wonder about things, to appreciate the esoteric things like music or art. Or baseball. What evolutionary advantage is there to enjoying something like baseball?”

***

It is late in the afternoon, and the lounge is starting to come to life for what passes for a happy hour in a salesman’s hotel. Ryan is talking about tying his shoes. “It’s amazing, tying your shoes, stuff like that,” he says. “It’s so simple that you don’t realize how hard it is, what it takes for a kid to learn to tie his shoes. I’ve had to learn it twice now – once when I was a kid, and now it’s like when they talk about tying your shoes, you think, ‘OK, what do I do now? Where does this go?’ I remember how I used to tie my shoes, but I don’t remember that now.” Then he’s talking about baseball and the basic drills he used to merely tolerate.

“Even today, before I came up, I saw pitchers taking ground balls, and that’s kind of monotonous,” he says. “I used to be like that, taking fly balls in the outfield and saying, ‘OK, let’s play some games now.’ Now, it’s just so much different, because I’ve learned how much work it takes just to get to the point where you can do that.”

The breakthroughs are coming more slowly now, and most of them are smaller things. Nobody’s rushing him – not his parents, or the doctors, or the Red Sox, or himself. There is no doppelganger left to Ryan Westmoreland, no fragile identity built from fame and talent and promise and all the transient and vaporous trace elements of modern celebrity. There is only the simple fact that he’s working at the job of rebuilding himself, a day at a time. Why, just recently he picked up a baseball and, for the first time since his fingertips went numb last year, he could feel the seams, every last damn one of them, like the beads on a rosary, and isn’t that just the greatest thing?